2022 IHUMAN Clinical Analysis Review Exam With Answers (33 Solved Questions)

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TodGouseauiHumanCaseStudy AnswersTod Gouseau57 y/o

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5' 10" (178 cm)197.0 1b (89.5 kg)Humanpatientsby KAPLAN)Reason for encounterLeft knee painReviewSubmitted on 01116/2022 17:26:17Case authored by: Jennifer Kherani, MD

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GradedApproachQuestionResponseInformationObtained ClinicNotesccHow can I help you today?My left knee is killing me. Andwhen mydaughter saw that Iwas limping and how red theknee was, she insisted that Icome in and get it checked out.Assoc sxDo you have any othersymptoms or concerns weshould discuss?Nope, just the knee pain andswelling.Assoc sxHave you been havingfevers?Nope no fever, no chills.EtiologyHave you had any trauma to yourknee(s)?No. Initially I thought I musthave hurt it at some point, but Ican't recall injuring it. The skinon the knee looks red, almostlike a sunburn, but I don'trememberhurting or bruisingit.GradedApproachQuestionResponseInformationObtainedClinic NotesOnsetWhendidthepaininyourknee(s) start?Two days ago it was just a mildache, but now it really hurts.OnsetWhen did your swelling start?With thepain but is gettingworse over the last couple ofdays.LocationDoes the pain in your knee(s)radiate someplace else?Where?It doesn't move anywhere. It'sjust in my left knee.

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OLD-CARTS for the HPIAsked X Not askedDurationCharacteristicsDoes the pain in your knee(s)come andgo?No, it's there constantly.Not

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CharacteristicsHave you had pain in yourknee(s) before?The knee pain? Now that youask, I did have some knee painlast year. I think it was the sameknee.It wasn't this bad and itwent away pretty fast. Do youthink it was the same thing?CharacteristicsHave you had swelling like thisbefore?I had slight knee swelling aboutayearagonowthatyoumentionit,butnothingliketoday.XCharacteristicsIs the pain in your knee(s)superficial (on the surface) ordeep inside?It feel like both inside andoutside.CharacteristicsWhat does the pain in yourknee(s) feel like?It started as an ache. Then itturned into a throbbing pain.Today I'm having trouble walkingbecause it hurts so much.AggravatingDoes anything make the pain inyour knee(s) better or worse?It tends to feel better if I rest,but it doesn't go away. I triedibuprofen, but that isn't helping.I haven't triedice or anything.Do you think I should? Walkingand bending hurts a hell of a lot.RelievingTiming/TreatmentsHow often does your knee painoccur?This is the first time I have everhad knee pain like this.

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SeverityHow severe (1-10 scale)isthe pain in your knee(s)?About 6-8 out of 10, dependingon what I'm doing. Can't putweight on it.HPI

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PMH, FH, SH as NeededAsked X Not askedGradedApproachQuestionResponseInformationObtained ClinicNotesPMHAre you taking any prescriptionmedications?Iwasjustdiagnosedwithhypertension, and mydoc gavemeaprescriptionforhydrochlorothiazide. I also takean aspirin a day. Figured it wascheap prevention with my dadhaving died of a heart attack.XSHCan you tell me about your diet?What do you normally eat?My doctor told me to eat betterand lose weight to keep mypressure down. I've been tryingto eat healthier theMediterranean diet. I've beeneating Greek salads withsardines at this new Greekrestaurant my new favoritemeal. I used to eat a lot ofburgers and steaks, but 11mtrying tocut down and be a"sardines guy."GradedQuestionResponseInformation ObtainedClinic NotesHave you noticed any bruising,bleedinggums, nose bleeds, orother sites of increased bleeding?No.

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SHDo you drink alcohol? If so, whatdoyoudrink andhowmanydrinks per day?A couple of beers maybe threewith dinner to help me winddown. But that's only two orthree times a week.Review of Systems (ROS)Select the major body systems that have not been touched on during the interview process for the HPI.Asked X Not asked

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Do you have problems with heat orcold intolerance, increased thirst,increasedsweating,frequenturination,or change in appetite?Nope.Doyouhaveproblemswithdizziness, fainting, spinning room,seizures,weakness,numbness,tingling, or tremor?None of any of that. It is hard to walkbecauseofmykneehurtingsomuch, but I wouldn't say it is weak.Doyouexperiencechestpaindiscomfortorpressure;pain/pressure/dizzinesswithexertionorgettingangry;palpitations;decreasedexercisetolerance; or blue/cold fingers andtoes?No

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Doyouexperienceshortnessofbreath, wheezing, difficulty catchingyourbreath,chroniccough,orsputum production?Nope.Do you have problems with nausea,vomiting,constipation,diarrhea,coffee grounds in your vomit, darktarry stool, bright red blood in yourbowel movements, early satiety, orbloating?No.

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Exams FeedbackPerformed Correctlyassess gait & stanceAn antalgic gait is characterized by a unilaterally shortened gait phase that limits the degree ofweightbearing on the painful side.blood pressureinspect skin overallVisualinspection of the skin should assess for signs of the following:Trauma o Systemic disease o Inflammation o Infectionpalpate extremitiesFor a patient presenting with knee pain, it is important to perform a thorough and comprehensiveexamination ofthe knee. This should involve:Inspection o Palpation o Range of motion o Stability o Strengthpulse reflexes-deep tendon o Youperformed the simulation correctly.respirationtemperature testrange of motion

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For a patient presenting with knee pain, it is important to perform a thorough and comprehensiveexamination of the knee. This should involve:InspectionPalpationRange of motionStabilityStrengthtest stabilityFor a patient presenting with knee pain, it is important toperform a thorough and comprehensiveexamination of the knee. This should involve:InspectionPalpationRange of motionStabilityStrengthtest strengthFor a patient presenting with knee pain, it is important to perform a thorough and comprehensiveexamination of the knee. This should involve:InspectionPalpationRange of motionStabilityStrength

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